Correlation of clinical and sonological features in cases of mastalgia without a palpable lump

Background: Mastalgia is defined as pain, dull ache or heaviness in the breast. The most common cause of mastalgia is Aberration of Normal Development and Involution (ANDI) of breast tissue [1]. It can occur during adolescence, pregnancy and perimenopause. Materials and methods: Patients with complaints of breast pain in the age group 15-64 years with clinically no palpable mass attending to the surgical OPD in a tertiary care hospital between August2013- August 2015 (two years) were included in the study. Out of 700 patients who presented with pain in one or both breast, 482 (68%) had fibroadenoma, 78 (11%) were fibroadenosis with nodularity in breast followed by 50 (7%) cases had abscess and 40 (5.7%) had mastalgia without any palpable lesion which are included in this study. Detail history with particular reference to age, duration of symptoms, side of preponderance, menstruation, marital status, parity, lactation, nipple discharge and tenderness are recorded. Pain is recorded by subjective numerical pain intensity scale of 0-10. Clinical findings with particular reference to tenderness, quadrants involved are recorded. Ultrasound of the breast was done for all cases and findings recorded to correlate with clinical features. Results: Regarding age distribution, 18 (45%) patients belong to age group 26-35 years followed by 11 (27.5%) in age group of 36-45 years. 8 (20%) of patients were in the age group of 15-25 years. Remaining 3 (7.5%) were above 46 years. 20 (50%) had symptoms of < 1 month duration, 10 (25%) had duration of 1 - 6 months, 3 (7.5%) had symptoms for more than 6 months.13 (32.5%) had pain on right side, 16 (40%) had pain on left side, 11 (27.5%) had pain both sides. Severity of pain varied from 1 – 10 with an average of 5.4. 36 (90%) are married, 4 (10%) are unmarried. 35 (87.5%) had children, 5 (12.5%) were nulliparous. 32 (80%) women are having regular menstrual cycles and 8 (20%) were not menstruating due to either following hysterectomy or attained menopause apart from 3 (7.5%) patients were lactating mothers. Conclusion: The sonological findings of altered echogenisity and cystic changes can be the baseline while starting the treatment in patients with mastalgia without palpable lesion. These findings will also guide in assessing the response and follow-up of these patients.